| Entity Name: | 1ST COMMUNITY PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Feb 2010 (15 years ago) |
| Date of dissolution: | 29 Feb 2020 (5 years ago) |
| Last Event: | PENDING REINSTATEMENT |
| Event Date Filed: | 29 Feb 2020 (5 years ago) |
| Document Number: | L10000017918 |
| FEI/EIN Number | 271932971 |
| Address: | 2775 OLD WINTER GARDEN RD., OCOEE, FL, 34761, US |
| Mail Address: | 2775 OLD WINTER GARDEN RD., OCOEE, FL, 34761, US |
| ZIP code: | 34761 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346554433 | 2010-07-30 | 2017-01-18 | 2775 OLD WINTER GARDEN RD, OCOEE, FL, 347612995, US | 2775 OLD WINTER GARDEN RD, OCOEE, FL, 347612995, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-656-0641 |
| Fax | 4076560643 |
Authorized person
| Name | J C |
| Role | PHARMACY MANAGER |
| Phone | 4076560641 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH24784 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002601000 |
| State | FL |
| Issuer | PK |
| Number | 2126064 |
| Name | Role | Address |
|---|---|---|
| CHIN A | Agent | 2775 OLD WIINTER GARDEN RD., OCOEE, FL, 34761 |
| Name | Role | Address |
|---|---|---|
| CHIN A | Managing Member | 2775 OLD WINTER GARDEN RD., OCOEE, FL, 34761 |
| Name | Role | Address |
|---|---|---|
| CHIN J | Manager | 2775 OLD WINTER GARDEN RD., OCOEE, FL, 34761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-24 | CHIN, A | No data |
| PENDING REINSTATEMENT | 2012-12-14 | No data | No data |
| REINSTATEMENT | 2012-12-13 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-12-13 | 2775 OLD WIINTER GARDEN RD., OCOEE, FL 34761 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-06-29 | 2775 OLD WINTER GARDEN RD., OCOEE, FL 34761 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-06-29 | 2775 OLD WINTER GARDEN RD., OCOEE, FL 34761 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-04-24 |
| ANNUAL REPORT | 2015-01-16 |
| ANNUAL REPORT | 2014-04-15 |
| ANNUAL REPORT | 2013-04-23 |
| REINSTATEMENT | 2012-12-13 |
| ADDRESS CHANGE | 2010-06-28 |
| Florida Limited Liability | 2010-02-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
